Therapeutic Drug Monitoring and Dose Optimisation in Oncology

  • Merrill J. Egorin
Part of the ESO Monographs book series (ESO MONOGRAPHS)

Abstract

Therapeutic drug monitoring, also frequently referred to as “clinical pharmacokinetics” or “applied pharmacokinetics”, has been described as the process of using drug concentrations, pharmacokinetic principles, and pharmacodynamic criteria to optimise drug therapy in individual patients [1]. Therefore, implicit in any discussion of therapeutic drug monitoring are the consideration and integration of certain aspects of pharmacokinetics and pharmacodynamics as well as those of laboratory, clinical, and economic reality. In beginning this discussion, it is worth noting that therapeutic drug monitoring is considered standard medical practice for many classes of drugs and the practice of “applied pharmacokinetics” is gaining increasing acceptance as an intrinsic and essential part of rational drug development. Although this chapter will deal with dose optimisation in individual patients, many of the concepts and issues addressed are equally applicable to the process referred to as “pharmacologically guided dose escalation” wherein pharmacokinetic/pharmacodynamic relationships elucidated in preclinical animal studies are used as a basis to move a drug through phase I clinical trials in the most rational and expeditious fashion.

Keywords

Toxicity Leukemia Oncol Doxorubicin Methotrexate 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1992

Authors and Affiliations

  • Merrill J. Egorin
    • 1
    • 2
  1. 1.Division of Developmental TherapeuticsUniversity of Maryland Cancer CenterBaltimoreUSA
  2. 2.Division of Medical Oncology, Department of MedicineUniversity of Maryland School of MedicineBaltimoreUSA

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